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Social Control of the Feeble-minded. Having identified and registered the feeble-minded population of the country, and having tabulated their social status, their developmental and personal history, their health, and all other relevant data, it will be necessary to make for these individuals such provisions as will ensure from them a maximum of production and a minimum of reproduction. The more one studies this matter the more does one realize the futility of drawing up any hard-and-fast inelastic schedule of treatment and care. We are dealing with human beings, each with its own peculiarly individual complexities, personal and environmental. It is when we come to consider care and treatment that we realize the essential fact that mental enfeeblement has to be regarded not as a disease but as a social problem. For convenience of description we classify the feeble-minded into grades according to the amount of their social inadequacy, but there is no prescriptive method of treating idiocy, imbecility, or moronity ; each case in each grade must be studied individually not only from the point of view of his personal defect, but in his relationships as a social unit with the world in which he lives and moves and has his being. The main objects of social control are —(1) To discourage and prevent the procreation of the unfit; (2) to render known defectives as socially adequate as possible. I. PREVENTING THE PROCREATION OF THE UNFIT. The principal means suggested for preventing the procreation of the unfit are —(a) Sterilization, (b) segregation, (c) marriage laws, (d) eugenic education of the public. (a) Sterilization. This has been the subject of considerable controversy, and I have had ample opportunity of discussing it with psychiatrists on my tour. Total removal of the sexual glands —castration in the male, ovariotomy in the female—requires little consideration here. Most people are agreed that the remote results of the operation are too uncertain to permit of its regular use. There is not much reliable literature to guide one in the matter, and I have met only two men who are really convinced as to the beneficial results to be expected —one was Dr. Martin Barr, the Medical Superintendent of the Boys' Training-farm at Elwyn, Pennsylvania, who has published a series of eighteen cases of asexualization, including several of castration, and he claimed to have noted marked mental improvement in all these cases; the other was Professor Aschaffenburg, of Cologne, who has had experience in connection with the castration of psychopathic sexual offenders. I seen only two cases of castration, and these showed no mental change whatever ; we know too little to make any recommendation in this direction. Vasectomy —severing and ligating the spermatic cord, the channel through which the sperms travel from the testes to the orifice —is a simple operation which can be performed in a few minutes under a local anaesthetic. The result is that the individual cannot procreate. He can still have sexual intercourse,' and his desires are not lessened by the operation. In the female the operation consists in severing and tying the tube through which the ova come to the uterus. This is an abdominal operation with very little risk, and the result is to prevent procreation without diminishing desire. The operation of eugenical sterilization is confined, so far as I know, to the United States. It has been practised upon the insane, the feeble-minded, and persons found guilty of certain sexual offences. Sterilization, laws have been passed in twenty-two States of the United States of America commencing with Indiana in 1907, ancl including New York in 1912 ; but it may be at once said that it is only in one State —California—that the law is functioning to any appreciable extent, while in several others it has been declared unconstitutional. The failure of the sterilization laws in America is often quoted as an argument against eugenic legislation elsewhere ; but it must be kept in view that this result has been arrived at through extrinsic factors unconnected with the operation as such. Legislation in America does not receive the same amount of preliminary consideration as we deem necessary in purely British countries, and laws are apt to appear on the statute-book in advance of public opinion, with the result that their operation provokes antagonism and revocation. This has been the history of the sterilization law in New York, where only nine operations have been performed. Repeals in most of the States have been due to the Acts being declared unconstitutional, not to the operation being found undesirable or ineffective in its results. The latest judgment of the Supreme Court of the United States has upheld the sterilization law of the State of Virginia. The case immediately affected by the decision was that of a feeble-minded young woman, the mother of a feeble-minded child, and whose mother had also been feeble-minded. Mr. Justice Holmes (son of Dr. Oliver Wendell Holmes), in giving judgment, said : "It would be better for all the world if, instead of waiting to execute degenerate offspring for crime or let them starve because of their imbecility, society would prevent those who are manifestly unfit from continuing their kind. The principle sustaining compulsory vaccination is broad enough to cover the proposition of sterilization." It is in California that sterilization has been carried out to the fullest extent, and I visited the Sonoma State Home for the feeble-minded, at Eldridge, California, and discussed the matter at great length with Dr. F. 0. Butler, the Medical Superintendent. The sterilization law of California is as follows :—

The, people of the State of California do enact as follows : —• Section I.—Section one of the Act entitled " An Act to provide for the Asexualization of Inmates of State Hospitals for the Insane, the Sonoma State Home, of Convicts in the State Prisons, and of Idiots," and repealing an Act entitled " An Act to permit Asexualization of Inmates of the State Hospitals and the California Home

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